Urinalysis (automated, with microscopy)
Facility: Ellinwood District Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $48
- Cash Discount Price: $59
- vs. Medicare Baseline: 15.14x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $3.17 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 1514% of the Medicare baseline (a markup of 1414%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Humana | $48 | 1514% |
| Cigna | $48 | 1514% |
| Aetna | $48 | 1514% |
| Blue Cross Blue Shield | $48 | 1514% |
| UnitedHealthcare | $48 | 1514% |
Consumer Guidance & Cost Commentary
For the automated urinalysis with microscopy at Ellinwood District Hospital in Ellinwood, KS, the facility's negotiated rates are consistently $48.00 across all five major payers, including Humana, Cigna, Aetna, Blue Cross Blue Shield, and UnitedHealthcare. This negotiated amount is significantly lower than the facility's gross charge of $69.00, reflecting the contractual agreements that cap what insurers pay. However, for patients with high-deductible plans, the cash price of $59.00 may be more cost-effective than relying on insurance, as commercial negotiated rates often include administrative overhead that pushes the final cost higher than the direct cash price. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket expenses than paying cash upfront.
The facility, a Critical Access Hospital owned by a government hospital district, has a cash median of $59.00, which is notably higher than the Medicare benchmark of $3.17 for this procedure. While the data does not provide specific state or county average comparisons for this exact code, the substantial difference between the Medicare rate and the facility's cash price highlights the potential for significant savings through prompt-pay discounts. Patients should proactively request a "self-pay" or "prompt-pay" discount before check-in to bypass insurance billing cycles, which can save up to 50% on the total bill. Additionally, since over 80% of hospital bills contain errors, requesting a detailed, itemized statement before payment is the most effective way to identify any unbundled codes or services not rendered, ensuring you are only paying